Abstract

Aim

The Spanish Lung Cancer Group (SLCG) undertook an industry-independent, two biomarker-directed, randomized trial in advanced NSCLC p. The study (NCT00617656/GECP-BREC) compared non-selected cisplatin-based chemotherapy with therapy customized according to BRCA1/RAP80 mRNA levels. The trial was closed prematurely due to a detrimental effect in the biomarker-directed arm. Further genetic analysis defined PALB2, the bridging molecule that connects BRCA1 and BRCA2, as a promising biomarker to elucidate DNA repair mechanisms.

Conclusions

Our findings reveal PALB2 to be a predictive and prognostic biomarker in advanced NSCLC p treated with docetaxel plus cisplatin. The BRCA1-PALB2-BRCA2 network is a critical determinant of responsiveness to DNA interstrand cross-linking agents and antimicrotubule agents. In our study, BRCA1 had no effect on treatment outcome of this population. PALB2 was found to be a strong marker to predict sensitivity to antimicrotubule agents, without affecting sensitivity to DNA damage-based chemotherapy.